In this study of patients with membranous nephropathy, serum samples from 70% of patients with idiopathic, but not secondary, membranous nephropathy were found to have antibodies against a 185-kD glycoprotein in nonreduced glomerular extracts, identified as the M-type phospholipase A₂ receptor (PLA₂R). PLA₂R is present in normal podocytes and in immune deposits in patients with idiopathic membranous nephropathy, indicating that PLA₂R is a major antigen in this disease.

In this longitudinal study of hospitalized Medicare patients, there was no improvement in survival after cardiopulmonary resuscitation (CPR) during the period from 1992 through 2005. The overall rate of survival to discharge of patients who underwent in-hospital CPR was 18.3%. Survival after CPR was lower among black patients than among white patients.

Combined positron-emission tomography and computed tomography (PET–CT) plus conventional staging was compared with conventional staging alone for preoperative staging of non–small-cell lung cancer (NSCLC). The end point was the number of futile thoracotomies in each group (with futility defined as a result other than potentially curable NSCLC). Preoperative staging of NSCLC with PET–CT was found to reduce the total number of thoracotomies and the number of futile thoracotomies.

This study aimed to determine whether early administration of drugs that block the renin–angiotensin system slows the progression of change in glomerular mesangial fractional volume and retinopathy progression of two steps or more, according to the retinopathy severity scale. Early blockade of the renin–angiotensin system did not modify nephropathy progression in patients with type 1 diabetes but had important effects in slowing retinopathy.

This study examined expenditures on drugs and other medical services before and after the implementation of Medicare Part D. For patients who had no drug coverage before Part D, the increase in drug spending after the implementation of Part D was approximately offset by a decrease in other medical spending. Improved access to medications may achieve savings in nonpharmacy costs because of better control of chronic illness.

The causes of acute rhabdomyolysis include trauma, drugs, toxins, and certain infections. Acute kidney injury is a dangerous complication of severe rhabdomyolysis. This review summarizes current views on the pathogenesis of myoglobin-induced kidney injury as well as on its prevention and treatment.

A 31-year-old man presented to the emergency department with pain in the left shoulder. He had tripped over his backpack shoulder strap earlier in the day and noted immediate severe pain around his left shoulder. Physical examination revealed bony point tenderness over the humeral head and limited range of motion due to pain; crepitus was present. Shoulder radiographs revealed an impacted fracture of the left humerus and evidence of osteopenia.

A recent study upends the hypothesis that cardiomyocytes are not renewed after the first weeks of life.